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Objective To estimate the cost-effectiveness of a medical office–based preventive oral health program in North Carolina called Into the Mouths of Babes (IMB). Design Observational study using Medicaid claims data (2000-2006). Setting Medical staff delivered IMB services in medical offices, and dentists provided dental services in offices or hospitals. Participants A total of 209 285 children enrolled in Medicaid at age 6 months. Interventions Into the Mouths of Babes visits included screening, parental counseling, topical fluoride application, and referral to dentists, if needed. The cost-effectiveness analysis used the Medicaid program perspective and a propensity score–matched sample with regression analysis to compare children with 4 or more vs 0 IMB visits. Main Outcome Measures Dental treatments and Medicaid payments for children up to age 6 years enabled assessment of the likelihood of whether IMB was …